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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 25 of 34. This is the beginning of the thread.
Posted by qbsbrown on March 28, 2009, at 20:32:41
I'm doing a valium taper right now. After 8 years of benzo use, I've been experiencing tolerance and interdose withdrawal for years.
I'm using a liver detox supplement (helps w/ my headaches), but wonder if it would make me process the valium quicker, thus making withdrawal symptoms worse.
Or is it safe and fine to be using?
Regards,
Brian
Posted by Larry Hoover on March 29, 2009, at 21:36:37
In reply to Liver supplements: make you process meds quicker?, posted by qbsbrown on March 28, 2009, at 20:32:41
> I'm using a liver detox supplement (helps w/ my headaches), but wonder if it would make me process the valium quicker, thus making withdrawal symptoms worse.
You'd have to be more specific about what's in the liver supp in order to give any sort of answer.
Lar
Posted by qbsbrown on March 29, 2009, at 23:48:45
In reply to Re: Liver supplements: make you process meds quicker? » qbsbrown, posted by Larry Hoover on March 29, 2009, at 21:36:37
http://www.gnc.com/product/index.jsp?productId=2133747
Vitamin B6 (Pyridoxine HCl) 10.00 mg 500%
artichoke extract (flower) 90.00 mg **
beet leaf 90.00 mg **
Dandelion Root 90.00 mg **
milk thistle extract (seed) 90.00 mg **
tumeric extract (rhizome) 90.00 mg **
black radish root 30.00 mg **
Inositol 10.00 mg **
Astaxanthin 500.00 mcg
Thanks Larry.Brian
Posted by Larry Hoover on March 30, 2009, at 8:06:25
In reply to Re: Liver supplements: make you process meds quicker?, posted by qbsbrown on March 29, 2009, at 23:48:45
> http://www.gnc.com/product/index.jsp?productId=2133747
>
> Vitamin B6 (Pyridoxine HCl) 10.00 mg 500%
> artichoke extract (flower) 90.00 mg **
> beet leaf 90.00 mg **
> Dandelion Root 90.00 mg **
> milk thistle extract (seed) 90.00 mg **
> tumeric extract (rhizome) 90.00 mg **
> black radish root 30.00 mg **
> Inositol 10.00 mg **
> Astaxanthin 500.00 mcg
>
>
> Thanks Larry.
>
> BrianWhat a mixture. It had to be complicated, eh?
At the level of the liver, I cannot find any direct action on the two major enzyme isoforms responsible for metabolizing diazepam, but there was potential for a possible minor pathway with questionable effect. Interestingly enough, turmeric inhibits the same two enzymes that black radish induces. I wonder what the net effect is? Neither affects diazepam, so I'm just reacting rhetorically.
I couldn't verify it absolutely, but there is probably some modest inhibition of intestinal uptake, however. The active constituents in milk thistle and artichoke (also a thistle) are actively transported from the gut by p-glycoproteins. Other pgp substrates are known to have reduced uptake when co-administered with the thistles, and diazepam is a pgp substrate. There are different pgp variants, so I can't be certain that they overlap. It's a competitive effect; if they ride the same bus, and the bus is already full, some passengers can't get where they're going.
So, in summary, I can't find any drug metabolism effects, but if the uptake transport is inhibited, then you're getting less valium into the blood than you'd expect from the dose you're taking (20-30% reduction in blood concentration of the drugs I found which were affected in this way). Now, that wouldn't matter at all if you've always been taking the liver supp during the period of tapering intake. It's already factored in.
BTW, why are you taking the liver supp? Are your AST and ALT elevated?
Lar
Posted by Larry Hoover on March 30, 2009, at 8:33:58
In reply to Re: Liver supplements: make you process meds quicker?, posted by qbsbrown on March 29, 2009, at 23:48:45
I apologize....I forgot to check astaxanthin.
Astaxanthin is a potent inducer of 3A4 in vitro. That would speed up the breakdown of valium by one pathway, if....if the dose given here is large enough to do anything. An in vivo study showing this effect is real used 100 mg, and the dose here is 1/200 of that. It's probably trivial, but I can't be certain.
Lar
Posted by qbsbrown on March 30, 2009, at 9:35:06
In reply to Re: Liver supplements: ooops! read this! » qbsbrown, posted by Larry Hoover on March 30, 2009, at 8:33:58
Senna? Smooth move tea? What wouldn't affect my valium taper? It's really bad, and I can go days w/o going, and it just makes me feel physically and emotionally like crap (no pun intended)
Regards,
Brian
is this too harsh?
http://www.iherb.com/ProductDetails.aspx?pid=5910
B vitamins are really bad for benzo withdrawal right?
Brian
Posted by Larry Hoover on March 30, 2009, at 10:51:46
In reply to What could I take for bad constipation?, posted by qbsbrown on March 30, 2009, at 9:35:06
> Senna? Smooth move tea? What wouldn't affect my valium taper? It's really bad, and I can go days w/o going, and it just makes me feel physically and emotionally like crap (no pun intended)
>
> Regards,
>
> Brian
>
> is this too harsh?
>
> http://www.iherb.com/ProductDetails.aspx?pid=5910
>
> B vitamins are really bad for benzo withdrawal right?
>
> BrianYou've got a lot going on, dude.
The gentlest option may not be to your taste, the glycerin suppository. Usually works in less than an hour.
Stimulant herbs enhance muscular contractions (peristalsis) in the bowel. When I was using opiates, I had to use such a product quite regularly. Mine had senna, but there are many herbs with this effect. You can only know what you're comfortable with by trying them.
When I was really in a fix, I used a Fleet enema.
None of these methods should affect your valium taper.
I don't know where you got the idea that B-vitamins were bad for benzo withdrawal. Some have modest stimulatory effects. Here's a product designed to relieve benzo withdrawal, and it contains B-vitamins. http://www.lifehealthsolutions.com/calm/neurecover-bz.html
http://www.lifehealthsolutions.com/calm/bz_symptom_reduction.htmlThat is not a testimonial to the specific product. I am simply showing that the product includes B-vitamins.
Lar
Posted by qbsbrown on March 30, 2009, at 11:51:05
In reply to Re: What could I take for bad constipation? » qbsbrown, posted by Larry Hoover on March 30, 2009, at 10:51:46
Yeah, I was on the website benzoisland.org, and they are against using any and all vitamins/supplements/medications during benzo withdrawal. The specifically said that none have been proven to help alleviate, many can worsen symptoms, especially they state the B vitamins.
Where can I buy glycerin suppositories?
Regards,
Brian
Posted by Larry Hoover on March 30, 2009, at 12:41:34
In reply to Re: What could I take for bad constipation?, posted by qbsbrown on March 30, 2009, at 11:51:05
> Where can I buy glycerin suppositories?
>
> Regards,
>
> BrianAny pharmacy should have them.
Lar
Posted by qbsbrown on March 30, 2009, at 12:51:02
In reply to Re: What could I take for bad constipation? » qbsbrown, posted by Larry Hoover on March 30, 2009, at 12:41:34
How many times a day is it ok to use? Should you be going three times regularly?
I'm lucky if i go once a week.
Regards,
Brian
Posted by Larry Hoover on March 30, 2009, at 19:20:34
In reply to Re: What could I take for bad constipation?, posted by qbsbrown on March 30, 2009, at 12:51:02
> How many times a day is it ok to use? Should you be going three times regularly?
>
> I'm lucky if i go once a week.
>
> Regards,
>
> BrianI'd be hard-pressed to say that once a week is in the normal range. With that as a baseline, I have to ask if you've been assessed by a medical doctor. If not, you should consult a doctor before you proceed with home remedies.
Lar
Posted by Larry Hoover on March 30, 2009, at 20:04:42
In reply to Re: What could I take for bad constipation? » qbsbrown, posted by Larry Hoover on March 30, 2009, at 19:20:34
> If not, you should consult a doctor before you proceed with home remedies.
>
> LarOkay, on further research, selt-treatment isn't a bad idea, so long as there's no blood in your stool.
Lar
Posted by qbsbrown on March 30, 2009, at 20:29:53
In reply to Re: What could I take for bad constipation?, posted by Larry Hoover on March 30, 2009, at 20:04:42
Yeah, the constipation is caused by the medication. As I taper lower and lower, I know that I'll be able to go.
Am I able to use the suppository more than once a day? Did it this morning, only a few rabbit pebbles.
Regards,
Brian
Posted by qbsbrown on March 30, 2009, at 20:44:27
In reply to Re: What could I take for bad constipation?, posted by qbsbrown on March 30, 2009, at 20:29:53
Larry, do you believe in the Dr. Heather Ashton protocol for benzo taper? Or is it more typical to reduce by 10 percent a week?
Hers is to go down 2mgs every 1-2 weeks, then when at 16mgs, go down 1mg every 1-2 weeks.
Is that an anti benzo community that is outside the norm?
Posted by Larry Hoover on March 31, 2009, at 8:33:27
In reply to Re: What could I take for bad constipation?, posted by qbsbrown on March 30, 2009, at 20:29:53
> Am I able to use the suppository more than once a day? Did it this morning, only a few rabbit pebbles.
>
> Regards,
>
> BrianYes, you can use it more than once a day. It's a local irritant. It draws fluid into the bowel, and induces muscle contractions. However, if the "yield" was rabbit turds, I'm going to suggest heavy artillery to get the backlog cleared out. The downside risk of severe constipation is called fecal impaction. A large stool forms that is too hard and too big to pass through the anus. It must be mechanically removed by medical personnel. The rabbit turd phenomenon is probably fragments breaking off such a hard mass, which can continue to enlarge.
Whenever that happened to me, I used a Fleet enema, which contains sodium phosphates. I could pick up a generic version for a couple of bucks, available at any pharmacy. It works rapidly, within 2 to 5 minutes.
After getting the "cork out of the bottle" I was usually able to maintain better flow with stimulant laxatives, with the occasional suppository.
Fleet enemas are not for routine use. But nobody wants this sort of constipation to be routine either.
Lar
Posted by Larry Hoover on March 31, 2009, at 8:41:48
In reply to Re: What could I take for bad constipation?, posted by qbsbrown on March 30, 2009, at 20:44:27
> Larry, do you believe in the Dr. Heather Ashton protocol for benzo taper? Or is it more typical to reduce by 10 percent a week?
>
> Hers is to go down 2mgs every 1-2 weeks, then when at 16mgs, go down 1mg every 1-2 weeks.
>
> Is that an anti benzo community that is outside the norm?Heather Ashton is performing a valuable service for the most sensitive of individuals, who thereby tend to be poorly served by conventional medical practise. In any larger group of subjects, there are going to be people who need to take extra care in managing a particular therapy, or, in this case, withdrawal from a therapy. Only you can say whether you need this special withdrawal regime, i.e. if you've had intolerable effects from a more aggressive taper.
Lar
Posted by qbsbrown on March 31, 2009, at 11:14:53
In reply to Re: What could I take for bad constipation? » qbsbrown, posted by Larry Hoover on March 31, 2009, at 8:41:48
Well, the serotonin does make me much more social for what it's worth.
Brian
Posted by qbsbrown on March 31, 2009, at 11:40:36
In reply to Re: What could I take for bad constipation? » qbsbrown, posted by Larry Hoover on March 31, 2009, at 8:41:48
> > Larry, do you believe in the Dr. Heather Ashton protocol for benzo taper? Or is it more typical to reduce by 10 percent a week?
> >
> > Hers is to go down 2mgs every 1-2 weeks, then when at 16mgs, go down 1mg every 1-2 weeks.
> >
> > Is that an anti benzo community that is outside the norm?
>
> Heather Ashton is performing a valuable service for the most sensitive of individuals, who thereby tend to be poorly served by conventional medical practise. In any larger group of subjects, there are going to be people who need to take extra care in managing a particular therapy, or, in this case, withdrawal from a therapy. Only you can say whether you need this special withdrawal regime, i.e. if you've had intolerable effects from a more aggressive taper.
>
>
Well I am very sensitive to meds, and don't tolerate them. I've attempted to come off of benzos 5-6 in the last couple of years, but each time it seemed like the taper was too fast. So perhaps the Ashton method is best for me.Regarding that link you sent me about a supplement for benzo withdrawal; do you think it's safe to be taking 5htp (30mg twice a day)during withdrawal (of course the benzoisland.org people say no, no supplements)?
My biggest problem through this taper is that I don't naturally get tired at night. I just somehow fall asleep. But without doubt, I wake up at 6am on the dot (any shade of light wakes me up), like a deer in the headlights, bad anxiety (my testicles up my stomach). No natural progression to waking up.
Although SSRIs helped my sleep, and makes me more social self, the other part made my life hell (gave me derealization, turned me into an irratable a-hole, made compulsions worse, worse depression, etc). I'm too chemically sensitive. They obviously aren't for me.
So conventional meds are out of the question for me.
Do you think that 5htp is beneficial? And is twice a day ok?
I do also believe/know that this severe constipation is making me feel physically and emotionally horrible.
Just tried the fleet enema, just a few rabit pellets.
I'll work the laxatives and glycerine as well.
Regards,
Brian
PS- I'm on rescue remedy, and 2 other bach flowers, plus 4 different homeopathic remedies, and they seem to be working! Other than the sleep problem.
Posted by qbsbrown on March 31, 2009, at 18:36:44
In reply to Re: What could I take for bad constipation?, posted by qbsbrown on March 31, 2009, at 11:40:36
Yeah Lar, even 5htp induces bipolar like symptoms (racing thoughts, mood instability), I can't tolerate anything serotonin.
Any other ideas of what could allow me to get naturally tired, and wake up refreshed, hopefully later than 6am, and w/o severe anxiety?
Or is this just part of the benzo withdrawal that I need to deal with?
Regards,
Brian
Posted by Sigismund on March 31, 2009, at 19:40:29
In reply to Re: What could I take for bad constipation?, posted by qbsbrown on March 31, 2009, at 11:40:36
>No natural progression to waking up.
This is what gets me doing my morning exercises at 4 in the morning while listening to Leonard Cohen .
Today was different though.
I woke at 3am with a start, and took 500mg niacinamide and 500mg tryptophan and slept till 6, and woke up almost naturally.....a minor miracle.
Posted by Sigismund on March 31, 2009, at 19:42:37
In reply to Re: What could I take for bad constipation?, posted by qbsbrown on March 31, 2009, at 18:36:44
So the tryptophan is not a good idea, I see.
If I couldn't take that and I had a benzo withdrawal I would get to a herbalist and get some zizyphus and skullcap.
Posted by Larry Hoover on March 31, 2009, at 22:42:28
In reply to Re: What could I take for bad constipation?, posted by qbsbrown on March 31, 2009, at 11:40:36
I don't understand why the fleet enema and the glycerin suppository have had such small effect. Is it possible that the fecal mass has not dropped down adjacent to the anus, into the lowest segment of the bowel? Do you have that feeling of pressure/urge to move the bowels? Or instead, just the fullness? Perhaps your peristalsis (rhythmic movement of fecal mass along the bowel) is weak to non-existent. In that case, a stimulant laxative (those herbs, e.g. senna, or the blend you mentioned) might do the trick. As would castor oil. The problem is that there are potentially serious disorders that involve significant decreases in peristalsis. That's why I asked earlier if you'd been assessed by a doctor. Tell you what, if you try a stimulant laxative, and it fails. And you increase the dose to the max and it fails again, go straight away to a doctor and tell him the sort of problem you're facing. Peristalsis is mediated by serotonin, but there's more to it than that.
Lar
Posted by qbsbrown on April 1, 2009, at 13:06:47
In reply to Re: What could I take for bad constipation? » qbsbrown, posted by Larry Hoover on March 31, 2009, at 22:42:28
Perhaps I'll give the 5htp a chance at night (100mgs). I took it during the day yesterday (20mg), and felt like crap. But I was awake at 3am this morning, as opposed to my usual 6am.
I'm sure this is part of benzo w/d, but it's outta hand. Last time I went through this, the doc added celexa, and it helped me sleep, but gave me a slough of problems.
Is the 5htp much more safe than the SSRIs? Less side effects?
Regards,
Brian
Posted by qbsbrown on April 5, 2009, at 18:22:25
In reply to Re: What could I take for bad constipation? » qbsbrown, posted by Larry Hoover on March 31, 2009, at 22:42:28
Larry, along with the constipation, I'm having very bad water retention and bloating. Any particular vitamins that help aleviate this? Magnesium?
Any other vitamins or supplements that you might recommend for benzo withdrawal?
Regards,
Brian
Posted by qbsbrown on April 5, 2009, at 19:12:53
In reply to Larry: What could I take for bad constipation?, posted by qbsbrown on April 5, 2009, at 18:22:25
If I drink a lot of prune juice, it gets everything out of my stomach. Nothing really solid, but gets rid of all that water retention.
Is too much prune juice dangerous? I know that sugar isn't good for benzo WD.
Brian
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